| 高胆红素血症新生儿尿TIMP-2和IGFBP7变化的临床研究 |
| 投稿时间：2025-08-02 修订日期：2025-08-29 点此下载全文 |
| 引用本文：苏敏,王冰洁,李政,王乐瑶,王珍惜,李丽,任漪.高胆红素血症新生儿尿TIMP-2和IGFBP7变化的临床研究[J].医学研究杂志,2026,55(1):134-138 |
| DOI：
10.11969/j.issn.1673-548X.2026.01.023 |
| 摘要点击次数: 79 |
| 全文下载次数: 45 |
|
| 基金项目:江苏省徐州市科技局基础研究计划项目(KC22068,KC22069)；江苏省卫生国际(地区)交流支撑计划项目 |
|
| 中文摘要:目的 探讨高胆红素血症新生儿尿金属蛋白酶组织抑制剂-2(tissue inhibitor of metallo-proteinase-2,TIMP-2)和尿胰岛素样生长因子结合蛋白7(insulin-like growth factor-binding protein7,IGFBP7)水平变化及其临床意义。方法 选择2023年11月~2025年1月徐州市中心医院新生儿科收治的胎龄≥35周且日龄≤7天的高胆红素血症新生儿进行前瞻性队列研究。按照血清总胆红素水平分为轻度组、中度组及重度组。记录患儿一般资料及尿量,测定入组后及光疗后血清总胆红素、血肌酐、血胱抑素C、尿TIMP-2和尿IGFBP7,并计算尿[TIMP-2]×。比较各组肾功能指标。结果 最终纳入新生儿高胆红素血症轻度组71例、中度组68例和重度组66例。重度组尿TIMP-2/尿肌酐、尿IGFBP7/尿肌酐和尿[TIMP-2]×[(49.38±11.43ng/mg、182.24±17.60ng/mg和90±22(ng/ml)2]均高于中度组[17.49±2.39ng/mg、161.47±28.47ng/mg和28±5(ng/ml)2]及轻度组[15.63±2.62ng/mg、156.87±29.93ng/mg和25±6(ng/ml)2],差异有统计学意义(P<0.01)；中度组与轻度组之间差异无统计学意义(P>0.05)。3组之间其他肾功能指标差异均无统计学意义(P>0.05)。光疗后重度组尿TIMP-2/尿肌酐、尿IGFBP7/尿肌酐和尿[TIMP-2]×明显下降[22.46±5.35ng/mg比49.38±11.43ng/mg、91.46±9.72ng/mg比182.24±17.60ng/mg、20±6(ng/ml)2比90±22(ng/ml)2],差异有统计学意义(P<0.001)。3组患儿尿量和血清肌酐均未达到新生儿急性肾损伤风险期诊断标准。结论 重度高胆红素血症会引起新生儿肾损伤指标升高,但损伤相对较轻、恢复较快。 |
| 中文关键词:高胆红素血症 金属蛋白酶组织抑制剂-2 胰岛素样生长因子结合蛋白7 新生儿 |
| |
| Clinical Study on Changes of Urinary TIMP-2 and IGFBP7 in Neonates with Hyperbilirubinemia. |
|
|
| Abstract:Objective To study the changes of urine tissue inhibitor of metallo-proteinase-2 (TIMP-2) and urine insulin-like growth factor-binding protein7 (IGFBP7) levels in neonates with hyperbilirubinemia and its clinical significance. Methods A prospective cohort study was conducted on neonates with hyperbilirubinemia who were admitted to the Department of Neonatology, Xuzhou Central Hospital from November 2023 to January 2025, with a gestational age of ≥35 weeks and a postnatal age of ≤7days. These neonates were divided into the mild group, the moderate group, and the severe group, according to the serum total bilirubin level. The general information and urine volume were recorded. Both the baseline and post-phototherapy level of serum total bilirubin, serum creatinine, serum cystatin C, urine TIMP-2, and urine IGFBP7, and [TIMP-2]× were recorded. Each renal function parameters were compared between each group. Results Finally, neonates with hyperbilirubinemia were divided into three groups:71 cases in the mild group, 68 in the moderate group, and 66 in the severe group. The urinary TIMP-2/Ucr, IGFBP7/Ucr, and [TIMP-2]× levels in the severe group [49.38±11.43 ng/mg, 182.24±17.60 ng/mg, 90±22 (ng/ml)2] were significantly higher than those in the moderate group [17.49±2.39ng/mg, 161.47±28.47ng/mg, 28±5(ng/ml)2] and the mild group [15.63±2.62ng/mg, 156.87±29.93ng/mg, 25±6(ng/ml)2], with statistically significant differences (P<0.01). There was no statistically significant difference in urinary TIMP-2 between the moderate group and the mild group (P>0.05). No statistically significant differences were observed in other renal function indexes among the three groups (P>0.05). In the severe group, a significant reduction in urinary TIMP-2/Ucr, IGFBP7/Ucr, and [TIMP-2]× levels was found after phototherapy [22.46±5.35ng/mg vs 49.38±11.43ng/mg, 91.46±9.72ng/mg vs 182.24±17.60ng/mg,20±6(ng/ml)2 vs 90±22(ng/ml)2], the differences were statistically significant (P<0.01). None of the cases met the diagnostic criteria for the risk stage of neonatal acute kidney injury in terms of serum creatinine or urine volume. Conclusion Severe hyperbilirubinemia may cause an increase in the indicators of renal injury in neonates, but the injury is relatively mild and recovery is rapid. |
| keywords:Hyperbilirubinemia Tissue inhibitor of metallo-proteinase-2 Insulin-like growth factor-binding protein7 Neonatal |
| 查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|
